title: Robotic surgical instruments for dexterity enhancement in thoracoscopic coronary artery bypass graft.
abstract: OBJECTIVE
  Endoscopically sutured vascular anastomoses are complex, time consuming, and require great dexterity. We decided to evaluate performance enhancement using a robotic device to create sutured coronary artery bypass anastomoses with endoscopic techniques in a plastic model.
  
  
  METHODS
  Seven coronary artery bypass anastomoses were endoscopically created in a plastic model using a robotic enhancement technology (Computer Motion, Goleta, CA). Anastomoses were created with a single running suture (7-0 monofilament). Our endpoints were operative time, intraoperative incidents, stability and dexterity of the robotic system, surgeon's fatigue, and anastomotic patency.
  
  
  RESULTS
  Operative time was 46+/-12 min (mean+/-SD). There were no intraoperative incidents. Patency was confirmed in all anastomoses. The system's stability and dexterity were high. Surgeon's fatigue was mild.
  
  
  CONCLUSIONS
  The use of robotic enhancement technology leads to an efficient performance of sutured coronary artery bypass anastomoses in a plastic model. The robotic device enhances dexterity, precision, and reduces surgeon's fatigue while preserving the quality of hand suturing.
authors.affiliation: The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Ruiz
authors.forename: N G
authors.initials: NG
authors.lastname: Smedira
authors.forename: F D
authors.initials: FD
authors.lastname: Loop
authors.forename: J F
authors.initials: JF
authors.lastname: Hahn
authors.forename: J H
authors.initials: JH
authors.lastname: Miller
authors.forename: C P
authors.initials: CP
authors.lastname: Steiner
authors.forename: M
authors.initials: M
authors.lastname: Gagner
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D019723:Endoscopes; D004868:Equipment Failure; D005069:Evaluation Studies as Topic; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000295:instrumentation*; D008953:Models, Anatomic; D012371:Robotics / Q000295:instrumentation* / Q000592:standards*; D013536:Suture Techniques; D020708:Thoracoscopes; D013997:Time Factors